Division of Orthopaedic Surgery, Clintec, Karolinska Institute, Karolinska University Hospital, K54, 141 86 Stockholm, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2012 Sep;20(9):1868-74. doi: 10.1007/s00167-011-1801-9. Epub 2011 Nov 27.
An initial step in the understanding of Achilles tendon dynamics is to investigate the effects of passive motion, thereby minimising muscle activation and reducing internal joint forces. Internal tendon dynamics during passive ankle joint motion have direct implications for clinical rehabilitation protocols after Achilles tendon surgery. The aim of this study was to test the hypothesis that tendon tissue displacement is different in different layers of the Achilles tendon during controlled passive ankle joint movements.
Ultrasound imaging was conducted on the right Achilles tendon of nine healthy recreationally active males. Standardised isokinetic passive dorsi-plantar-flexion movements were performed with a total range of motion of 35°. The tendon was divided into superficial, central and deep layers in the resulting B-mode ultrasound images viewed in the sagittal plane. A block-matching speckle tracking algorithm was applied post-process, with kernels for the measurement of displacement placed in each of the layers.
The mean (SD) displacement of the Achilles tendon during passive dorsiflexion was 8.4 (1.9) mm in the superficial layer, 9.4 (1.9) mm in the central portion and 10.4 (2.1) mm in the deep layer, respectively. In all cases, the movement of the deep layer of the tendon was greater than that of the superficial one (P < 0.01).
These results, achieved in vivo with ultrasonographic speckle tracking, indicated complex dynamic differences in different layers of the Achilles tendon, which could have implications for the understanding of healing processes of tendon pathologies and also of normal tendon function.
了解跟腱动力学的第一步是研究被动运动的影响，从而最大限度地减少肌肉激活并降低内部关节力。被动踝关节运动过程中跟腱内的动力学变化直接影响跟腱手术后的临床康复方案。本研究旨在验证以下假设，即在受控的被动踝关节运动过程中，跟腱的不同组织层在不同的组织层中具有不同的位移。
对 9 名健康的娱乐性男性的右侧跟腱进行超声成像。使用总运动范围为 35°的标准化等速被动背屈 - 跖屈运动。在矢状面查看的 B 型超声图像中将跟腱分为浅层、中层和深层。应用块匹配散斑跟踪算法进行后处理，在每个层中放置用于测量位移的核。
在被动背屈过程中，跟腱的平均（SD）位移分别为浅层 8.4（1.9）mm，中层 9.4（1.9）mm和深层 10.4（2.1）mm。在所有情况下，跟腱深层的运动都大于浅层（P<0.01）。
这些结果是通过超声斑点跟踪在体内获得的，表明跟腱不同组织层之间存在复杂的动态差异，这可能对了解肌腱病变的愈合过程以及正常肌腱功能具有重要意义。
